| Anita Laviola, Lcsw,csac Llc | |
|
2200 Main St Ste 528 Wailuku HI 96793-1640 | |
| (808) 281-2340 | |
| Not Available |
| Full Name | Anita Laviola, Lcsw,csac Llc |
|---|---|
| Speciality | Counselor |
| Location | 2200 Main St Ste 528, Wailuku, Hawaii |
| Authorized Official Name and Position | Anita Louise Laviola (OWNER) |
| Authorized Official Contact | 8082812340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anita Laviola, Lcsw,csac Llc Po Box 1052 Kula HI 96790-1052 Ph: (808) 264-4457 | Anita Laviola, Lcsw,csac Llc 2200 Main St Ste 528 Wailuku HI 96793-1640 Ph: (808) 281-2340 |
| NPI Number | 1871162677 |
|---|---|
| Provider Enumeration Date | 06/24/2021 |
| Last Update Date | 06/24/2021 |
| Certification Date | 06/24/2021 |
| Medicare PECOS PAC ID | 9032506977 |
|---|---|
| Medicare Enrollment ID | O20220425001147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871162677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Anita Laviola |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477728665 PECOS PAC ID: 3971804535 Enrollment ID: I20180814004336 |
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